Signature Albany Hospice | RN Case Manager | Albany, OR

Signature Healthcare at Home•Albany, OR

About The Position

The Registered Nurse plans, organizes and directs hospice care and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from the resources of the community to plan and direct services to meet the holistic needs of individuals and families within their homes and communities with an emphasis on palliative care. The Registered Nurse will be dedicated to the Mission, Values and Care Commitments of Signature Healthcare at Home and embrace and demonstrate our mission: “To Enhance The Life Of Every Person We Serve.” ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES: Patient Care 1. Completes an initial, comprehensive and ongoing comprehensive assessment of patient and family/caregiver to determine hospice needs. Provides a complete physical assessment and history of current and previous illness(es). 2. Provides professional nursing care by utilizing all elements of nursing process and as defined in the state Nurse Practice Act. 3. Assesses and evaluates patient’s status by: A. Establishing the initial individualized plan of care in collaboration with the attending physician, if any, and hospice medical director based on comprehensive assessment and patient goals. B. Regularly re-evaluating patient and family/caregiver needs. C. Participating in revising the plan of care in collaboration with the attending physician, if any, and hospice medical director as the patient status and needs change. 4. Develops a care plan that establishes interventions and goals incorporating palliative nursing actions. Includes the patient and the family/caregiver in the planning process. 5. Works autonomously to initiate appropriate preventive and palliative care nursing procedures. Administers medications and treatments as prescribed by the physician in the physician’s plan of care. 6. Involves the patient and family/caregiver to address needs and meet related goals. 7. Provides health care instructions to the patient as appropriate per assessment and plan. 8. Facilitates the patient’s efforts toward self-sufficiency or obtaining appropriate caregiving and optimal comfort care. 9. Acts as Case Manager when assigned by Clinical Manager and assumes responsibility to coordinate patient care for assigned caseload. Communication 1. Documents patient services and status timely and accurately within professional practice standards and reimbursement requirements. 2. Records pain/symptom management changes/outcomes as appropriate. 3. Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required. 4. Communicates with community health related persons to coordinate the care plan. 5. Teaches the patient and family/caregiver self-care techniques as appropriate. Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers. Works in concert with the interdisciplinary group. 6. Assists the patient and family/caregiver and other team members in providing continuity of care. 7. Works in cooperation with the family/caregiver and hospice interdisciplinary group to meet the emotional needs of the patient and family/caregiver. 8. Attends required staff meetings and interdisciplinary group meetings. Additional Duties 1. Participates in on-call duties as defined by the on-call policy. 2. Ensures that arrangements for equipment and other necessary items and services are available. 3. Supervises ancillary personnel and delegates responsibilities when required. 4. Coordinates patient care in tandem with LPN/LVN as assigned by Clinical Manager. 5. Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and inservice classes. 6. Fulfills the obligation of requested and/or accepted case assignments. 7. Actively participates in quality assessment performance improvement teams and activities or other committees as assigned. 8. May be required to work outside of designated geographical area based on census fluctuations and current staffing. 9. Completes mandatory education requirements annually to maintain competence. 10. May be required to visit patients in homes that are not clean, or in poor repair, have poor ventilation, are infested with insects or rodents, and secondhand smoke. 11. Driving conditions may be difficult related to weather and/ or traffic. 12. Maintains knowledge of and adheres to all applicable laws, rules, and standards. 13. Participates in the orientation of new employees and preceptorship of students as assigned. 14. Meets productivity expectations. The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job.

Requirements

Graduate of an accredited school of nursing.
One (1) to two (2) years of recent acute care experience in an institutional setting
Currently licensed as a Registered Nurse in the State(s) of planned practice.
Possesses and maintains CPR certification.
Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order.
Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist.
Self-directed and able to work with minimal supervision.
Capable of prolonged or considerable walking or standing. Able to lift, position and/or transfer patients. Able to lift supplies and equipment. Capable of considerable reaching, stooping bending, kneeling, and/or crouching. Possesses visual acuity and hearing to perform required nursing skills.

Nice To Haves

One (1) to two (2) years of recent experience in hospice preferred.

Responsibilities

Completes an initial, comprehensive and ongoing comprehensive assessment of patient and family/caregiver to determine hospice needs.
Provides professional nursing care by utilizing all elements of nursing process and as defined in the state Nurse Practice Act.
Assesses and evaluates patient’s status
Develops a care plan that establishes interventions and goals incorporating palliative nursing actions.
Works autonomously to initiate appropriate preventive and palliative care nursing procedures.
Administers medications and treatments as prescribed by the physician in the physician’s plan of care.
Involves the patient and family/caregiver to address needs and meet related goals.
Provides health care instructions to the patient as appropriate per assessment and plan.
Facilitates the patient’s efforts toward self-sufficiency or obtaining appropriate caregiving and optimal comfort care.
Acts as Case Manager when assigned by Clinical Manager and assumes responsibility to coordinate patient care for assigned caseload.
Documents patient services and status timely and accurately within professional practice standards and reimbursement requirements.
Records pain/symptom management changes/outcomes as appropriate.
Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required.
Communicates with community health related persons to coordinate the care plan.
Teaches the patient and family/caregiver self-care techniques as appropriate.
Assists the patient and family/caregiver and other team members in providing continuity of care.
Works in cooperation with the family/caregiver and hospice interdisciplinary group to meet the emotional needs of the patient and family/caregiver.
Attends required staff meetings and interdisciplinary group meetings.
Participates in on-call duties as defined by the on-call policy.
Ensures that arrangements for equipment and other necessary items and services are available.
Supervises ancillary personnel and delegates responsibilities when required.
Coordinates patient care in tandem with LPN/LVN as assigned by Clinical Manager.
Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and inservice classes.
Fulfills the obligation of requested and/or accepted case assignments.
Actively participates in quality assessment performance improvement teams and activities or other committees as assigned.
May be required to work outside of designated geographical area based on census fluctuations and current staffing.
Completes mandatory education requirements annually to maintain competence.
Maintains knowledge of and adheres to all applicable laws, rules, and standards.
Participates in the orientation of new employees and preceptorship of students as assigned.
Meets productivity expectations.